Female Hair Loss and Treatment

Hair loss, and subsequent baldness, is a condition that is often associated with men but hair loss is also quite common in women. Most men can get away with it, but for women, excessive hair loss is depressing and demoralizing. Fortunately, there are ways for women to fix their hair loss.

INTRODUCTION

Male and female pattern hair loss is the exact same entity. The only difference between the two is the pattern itself. In each hair cycle, the diameter of the hair shaft gets progressively smaller, which is known as miniaturization. Miniaturization is needed for the hair to completely fall out. Once it falls out, it still has the potential to regrow and thicken. Over time, however, it becomes irreversible or permanent.

The hair cycle lasts for about three or four years. Sometimes there can be inciting factors that will accelerate the cycle such as having thyroid disorders, iron deficiency or hormonal changes.

Hair loss in men involves hairlines that actually recede and make them look bald. In addition, there’s the crown or the vertex of the scalp that fully opens up as well. Together, it is a pattern that looks almost like a horseshoe or a cul-de-sac. In women, the frontal hairline is preserved and the loss is more on the top part of the scalp. In the worst cases, you can completely see the scalp.

TREATMENT OPTIONS

Hair transplants are available to solve the problem of hair loss in females. There’s only one way to do a hair transplant, but there are two ways of harvesting donor hair. The process of transplanting hair is known as Follicular Unit Transplantation.  The methods of extracting hair follicles are called strip harvesting and Follicular Unit Extraction (FUE).

In strip harvesting, an area at the back of the scalp is shaved. The area must exhibit good hair growth. A linear incision is made to remove these hair-rich strips from the donor site. The follicles will then be planted in the other area of the scalp where hair loss has occurred.

FUE, on the other hand, involves harvesting follicles one by one. Each follicle is removed using tiny punches as small as 0.6mm in diameter. The follicles, which contain one to four hairs, are planted in place and arranged in a manner that makes them look natural and realistic.

In most cases, when it comes to treating female pattern baldness, females are not good candidates for hair transplantation. Females don’t have much space in-between hairs to collect the grafts because they haven’t lost enough hair. Furthermore, cases of female baldness often just require filling in hairs between existing hairs as opposed to men whose problem is mostly restoration of the frontal hairline.

If a female is a candidate for hair transplantation, strip harvesting is usually considered. Since most females have long hair, the scar that results from such a method won’t really be much of a problem.

ALTERNATIVE TREATMENTS

Some female patients may also benefit from taking medications, such as Minoxidil and even finasteride in certain conditions, which are more popularly known by their respective brand names Rogaine and Propecia.

Rogaine, which directly stimulates hair growth, usually comes in topical form which needs to be applied to the affected area once a day. Improvements will not be seen unless you use it regularly for at least six months. Patients need to keep in mind that Rogaine is only meant for slowing down the rate of hair loss.

Propecia, on the other hand, exerts its effect on dihydrotestosterone (DHT)—the very hormone that causes hair loss. DHT, an active metabolite of the male hormone testosterone, causes hair follicles to shrink. Propecia works by blocking the effect of DHT on the hair follicles. This drug is normally recommended for males only, but in some cases practitioners might need to prescribe it to their female patients. The reasons why it is not intended for females, particularly those of child-bearing age, include the following:

• It is not as effective in females as it is in males
• If taken by a pregnant woman, it may cause birth defects to her unborn baby

CANDIDACY

A hair transplant is recommended in females with advanced androgenetic alopecia. In such cases, there’s a need to at least have a hair transplant in addition to medical therapy. Mild cases of hair loss, on the other hand, must be treated with medications first.

Another important thing that matters when deciding about a hair transplant is donor density. If the amount of hair growing on the prospect donor area is less than desirable, the patient may be advised to undergo low level light stimulation (LLLT) to stimulate hair growth. Some studies have shown that LLLT can increase the diameter of the hair shaft, therefore that may increase density overall. LLLT may be used as a stand-alone treatment especially if the patient is not a good candidate for other treatments.

Finally, some patients may also need Platelet-Rich Plasma (PRP) injections prior to the transplant. PRP is injected after the graft has been transplanted into its new position to allow the hair to thicken up and provide better coverage on the new site. It also helps the graft to survive better and heal faster. Treatment with PRP requires two to three sessions with intervals of four to six weeks.

ESTIMATED COSTS

The cost of a hair transplant generally depends on how many grafts are needed. Treatment with PRP requires an additional fee which is anywhere from $700 to $1500 depending on the clinic’s location and the patient’s treatment needs.

LIMITATIONS AND RISKS

As mentioned previously, strip harvesting may cause scarring which can be permanent. In females, since the strip is always taken from the back of the scalp, scarring is not really a concern. No one would notice the scar unless the patient shaves the back of their head and expose it intentionally.

Treatments with LLLT likewise don’t cause serious risks. Studies have shown that it is very safe and produces no complications. The same goes for PRP treatment where the plasma that will be used on the patient will come from the patient’s own blood.

RESULTS

The goal of hair transplantation is to restore lost hair without making it obvious that the patient has had a hair transplant. In other words, it is all about giving that natural look that will last indefinitely after the procedure.

In order to do that, practitioners distribute the hair properly especially if the transplant will be on the frontal scalp. Designing a hairline is not usually done in females, but if needed, the practitioner will consider what looks natural. Most people have a very irregular hairline if you look closely, so designing a very straight hairline doesn’t look natural at all—even in females. 

The results of a hair transplant, if properly done, should last for a very long time.  This is especially true if it is coupled with other hair loss treatments.

CONCLUSION

Please note that hair loss in general is a chronic condition that will continue even when taking medications or doing treatments. You can slow down its rate but you can never really cure it because it is part of the natural aging process. It is much like any chronic condition such as hypertension.  There are medications for it but you can’t totally cure it.

Written by Cosmetic Town Editorial Team - AA

Based on an exclusive interview by Dr. Meena Singh in Shawnee, KS